Repub­li­can law­mak­ers move to seal ACA’s fate

Honolulu Star-Advertiser - - NATION - By Steven T. Den­nis Repub­li­can House speaker

WASH­ING­TON >> The pres­sure is now on U.S. House Repub­li­cans to com­plete the first step to­ward re­peal­ing Oba­macare af­ter a ra­zor-thin Se­nate vote showed the con­tentious­ness sur­round­ing ef­forts to undo Pres­i­dent Barack Obama’s sig­na­ture do­mes­tic achieve­ment. The House plans to vote as early as to­day on a bud­get res­o­lu­tion that would set the re­peal ef­fort in mo­tion, but the tim­ing could slip be­cause of in­tra­party angst. Doubts were grow­ing among both mod­er­ate and con­ser­va­tive Repub­li­cans about the wis­dom of vot­ing for re­peal with­out lay­ing out more de­tails about the even­tual re­place­ment.

A top House leader said Thurs­day that there’s enough sup­port to ap­prove the mea­sure in to­day’s sched­uled vote.

“Oh yeah, we’ll be fine,” Ma­jor­ity Leader Kevin McCarthy of Cal­i­for­nia said in a brief in­ter­view. Pres­i­dent-elect Don­ald Trump said on Twit­ter, “Con­grats to the Se­nate for tak­ing the first step to #Re­pealOba­macare — now it’s onto the House!”

Even so, Den­nis Ross of Florida, a se­nior House deputy whip, said Wed­nes­day he’s been ad­vised by a col­league that more Repub­li­can votes must be found to adopt the res­o­lu­tion, since all Democrats are ex­pected to op­pose it. Ross said GOP lead­ers are pre­par­ing for the pos­si­bil­ity that the vote might have to be moved to Satur­day to al­low more time to as­sem­ble sup­port. Some House Free­dom Cau­cus mem­bers are op­posed to the cur­rent plan, while Char­lie Dent of Penn­syl­va­nia, who co-chairs a group of mod­er­ate Repub­li­cans, said he has “se­ri­ous reser­va­tions” at this point about vot­ing for the bud­get. The 51-48 Se­nate vote early Thurs­day fell al­most en­tirely along party lines. Se­nate Repub­li­cans held to­gether to de­feat Demo­cratic amend­ments aimed at de­fend­ing pop­u­lar por­tions of the Af­ford­able Care Act, in­clud­ing ex­panded Med­i­caid and Medi­care drug ben­e­fits and al­low­ing kids to stay on their par­ents’ in­sur­ance un­til 26.

Work on re­place­ment

Repub­li­cans in­tend to come up with the re­peal bill in the com­ing weeks, though they re­main far apart over how it would work.

“We are not hold­ing hard dead­lines be­cause we want to get it right,” House Speaker Paul Ryan of Wis­con­sin told re­porters Thurs­day. “We are go­ing to do this the way Congress is sup­posed to work, but we do feel the need to do it quickly.”

The bud­get blue­print lets Repub­li­cans re­peal much of Oba­macare with­out any votes from Democrats, be­cause fol­low-on leg­is­la­tion wouldn’t be sub­ject to fil­i­busters.

GOP lead­ers ini­tially dis­cussed set­ting an Oba­macare re­peal some­time months or even years in the fu­ture, with a re­place­ment to be en­acted by that date. But a re­volt by rank-and-file mem­bers in both cham­bers, with ap­par­ent agree­ment from Trump, has law­mak­ers look­ing for a near-si­mul­ta­ne­ous re­peal and en­act­ment of a new health care law sev­eral weeks or months into the new ad­min­is­tra­tion. The bud­get res­o­lu­tion sets a Jan. 27 tar­get for writ­ing the first Oba­macare re­place­ment bill. A group of five Repub­li­cans pro­posed chang­ing that tar­get to March 3, but they with­drew the amend­ment late Wed­nes­day af­ter GOP lead­ers re­as­sured them that there was no prac­ti­cal dif­fer­ence be­cause miss­ing the dead­line doesn’t carry a penalty.

Sen. Rand Paul of Ken­tucky said he voted against the bud­get res­o­lu­tion for an un­re­lated rea­son: It would al­low the fed­eral debt to in­crease by more than $9 tril­lion over the next decade. Repub­li­cans con­trol the Se­nate 52-48, which meant that Repub­li­cans could af­ford only a sin­gle ad­di­tional de­fec­tion to ad­vance the mea­sure be­fore Trump’s in­au­gu­ra­tion.

The “vote-a-rama” pro­ce­dure for bud­get res­o­lu­tions al­lows Democrats to force un­lim­ited votes on amend­ments, which meant hours of votes be­fore fi­nal approval of the mea­sure. Democrats tried to use the ———

amend­ments to demon­strate a split be­tween where the coun­try is on pop­u­lar pro­vi­sions and the Repub­li­can base.

“The Repub­li­cans can­not please their base and the broader pub­lic at the same time,” Demo­cratic leader Chuck Schumer of New York said on the Se­nate floor. “From a pol­icy per­spec­tive, they can’t re­peal the law and keep in place the pro­vi­sions that are over­whelm­ingly pop­u­lar with a ma­jor­ity of Amer­i­cans. That’s why they’re in such a pickle.”

Re­solv­ing differences

Sen. Bernie San­ders of Ver­mont, the lib­eral in­de­pen­dent who sought the Demo­cratic pres­i­den­tial nom­i­na­tion last year, said Thurs­day he would be hold­ing ral­lies na­tion­wide to use op­po­si­tion Oba­macare re­peal as a way to bol­ster Democrats. Ideally, lead­ers want the House to adopt the Se­nate res­o­lu­tion this week and move on, but it’s not clear yet whether Speaker Paul Ryan will have the votes to do so with­out changes to as­suage his restive con­fer­ence. Among the differences Repub­li­cans are strug­gling with are how to treat states that ex­panded Med­i­caid un­der Oba­macare — a pri­or­ity for some Repub­li­can sen­a­tors — and whether to im­me­di­ately re­peal all of the Oba­macare taxes or keep some of them in place for now to en­sure fund­ing for a ro­bust re­place­ment. Trump said Wed­nes­day that he plans to weigh in on the out­lines of a re­place­ment af­ter he takes of­fice. “We’re go­ing to be sub­mit­ting, as soon as our sec­re­tary’s ap­proved, al­most si­mul­ta­ne­ously, shortly there­after, a plan,” Trump told re­porters. “We’re go­ing to do re­peal and re­place, very com­pli­cated stuff, and we’re go­ing to get a health bill passed.”

Ge­or­gia Repub­li­can Rep. Tom Price, the pres­i­dent-elect’s pick for health and hu­man ser­vices sec­re­tary, faces a hear­ing next week in front of the Se­nate’s health com­mit­tee, although the key hear­ing for his con­fir­ma­tion hasn’t yet been sched­uled.

We are not hold­ing hard dead­lines be­cause we want to get it right.” Paul Ryan

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